'We're up lanes no cars should have to go on'

Nurses left out of pocket while they object to new HSE mileage scheme

PUBLIC Health Nurses in Cavan and Monaghan who refuse to engage with a new HSE system for claiming travel expenses are not being paid their allowance until they comply, the Celt has learned.

For five months, a number of community nurses refused to use the new system for filing travel expenses because they felt it was “unnecessarily burdensome” and took them "away from patient care”.

Although they continued to visit patients in their homes, the HSE did not reimburse nurses for the expenses they incurred during that period.

The nurses were paid in full, however, when they filed their expenses in the way the HSE required.

“Everyone’s fed up,” nurse Fidelma McCabe told the Celt. “Some of us have given up because you can’t survive without your mileage, and we were fighting for months and months and months.

“We are so frustrated,” the nurse with 20 years’ experience added.

“Younger nurses who have mortgages and childcare costs had to give in.”

So far, only public health nurses in Cavan-Monaghan are required to use the new scheme, which was introduced to them under the National Integrated Staff Records and Pay Programme (NISRP), though it is expected to be rolled out nationally.

Under the new scheme, nurses are required to travel to patients’ homes by the route determined by Google Maps and keep a record of the Eircode of each property before leaving for the next patient’s house.

Nurses argue using Google Maps may be suitable for HSE staff attending meetings in Dublin but is “nonsensical” on the rural roads of Cavan-Monaghan. It also does away with years of local knowledge.

“Google Maps is so variable,” Fidelma said. “We’re sent up lanes and roads no car should be on.

“For example, all of us know to avoid the bottleneck on the main road into Virginia on a Friday afternoon.

“We would all use our own common sense and take the back roads we know, but we have to sit in the Dublin traffic because that’s how Google Maps tells us to go.”

Fidelma McCabe, who turns 60 next month, is a nurse working from Virginia Health Centre. She was also an employee rep for the Irish Nurses and Midwives Organisation (INMO) union until she gave up that role ahead of her retirement from nursing in four months’ time.

Under the old system, nurses took a mileage reading from their car’s odometer when they left the health centre to do call-outs and a second reading when they got back to base.

“When I left a patient’s house, I used to think ‘I need to ring the GP, do a swab and ring the lab etc’” Fidelma said. “Now, the new system wants me to put in an Eircode for patient A, work out how many kilometres that is then go to patient B and put in the Eircode there.

“We’re coming back in the evenings to spend an inordinate amount of time filling in mileage forms. It’s done mostly on our own time, for which we are not getting paid and it takes forever.”

She explained that nurses in the Public Health Nurse service use their own cars, which they also tax, NCT and insure from their own pockets “for use by the HSE”.

Fidelma’s husband is a mechanic. He has seen for himself the wear and tear the extensive mileage his wife clocks up on their car for work as a public health nurse incurs.

“When my husband told me, he didn’t want me to use our car when I wasn’t even getting paid for it, I had to agree,” Fidelma told the Celt.

When Fidlema said she could only do house calls if the HSE provided her with transport, she was told she would be recorded as being “on annual leave” if she didn’t carry out her home visits.

The INMO began the HSE’s internal grievance process, but the nurse’s complaint and a subsequent appeal was not upheld. Fidelma fears the next stage of the process, which is bringing a case to the Work Relations Commission, could take months. “People have bills to pay,” she said.

While most colleagues have “given in”, Fidelma says some “stalwarts” are continuing to fight for what they believe is common sense and what they are entitled to.

The Anglo-Celt put each of Fidelma’s complaints to the HSE. The national health service sent in the following statement: “All claims are processed in line with the HSE National Financial Regulations (NFR B-4), which require that expenses are incurred wholly and necessarily in the performance of official duties and are fully supported by receipts and journey details. Claims must be accurate, detailed and properly approved before payment.

“Training and guidance were provided to staff ahead of implementation, and Line Managers continue to support employees and ensure compliance with HSE national financial regulations.”

Meanwhile, Fidelma McCabe says she is retiring early from the Public Health Nurse Service because she fears “if I stayed I’d be a wreck”.

“If things were different I’d stay on,” the experienced nurse said.